Effects of chewing gum and LI4 acupressure on gastrointestinal recovery after cesarean section: A randomized controlled trial.

BACKGROUND

Postoperative gastrointestinal dysfunction is a frequent complication after cesarean section (CS), delaying recovery and causing discomfort. This study assessed the effects of chewing gum (CG) and LI4 acupressure-each compared with routine care-on gastrointestinal recovery after elective CS.

METHODS

In this three-arm randomized controlled trial, 105 women undergoing elective CS were randomly allocated to CG plus routine care, acupressure plus routine care, or routine care alone (n = 35 each). Interventions were applied three times daily for two days. Primary outcomes were time to first gas passage and defecation; secondary outcomes included time to mobilization, postoperative abdominal pain (measured at six time points), and nausea/vomiting incidence. Analyses employed Kaplan-Meier survival curves, repeated-measures ANOVA, and chi-square tests.

RESULTS

Both CG and acupressure groups showed significantly faster recovery than routine care, with shorter times to first gas passage, defecation, and mobilization (all p < 0.001). No significant differences were observed between CG and acupressure for these measures. A significant time × group interaction for pain (p = 0.025) indicated greater and more sustained relief in the acupressure group (all p < 0.05 vs. other groups). Nausea and vomiting rates were lower in intervention groups, though differences were not statistically significant.

CONCLUSIONS

Chewing gum and LI4 acupressure each significantly enhanced postoperative gastrointestinal recovery after CS compared with routine care, while acupressure provided superior pain control. These simple, non-pharmacological methods may improve maternal recovery and comfort. Trial registration: Iranian Registry of Clinical Trials,IRCT20200206046395N3 (https://irct.behdasht.gov.ir/).